Optimization of the Care Pathway for Patients With Chronic Pain: Assessing the Value of Integrating Sleep Specialists

Inclusion Criteria:

• First consultation at the pain management center
• Patient with chronic pain as defined by the "Haute Autorité de Santé". The pain musthave several of the following characteristics:
• Persistence or recurrence
• Duration beyond what is usual for the presumed initial cause, especially if thepain has been evolving for more than 3 months;
• Inadequate response to treatment;
• Important and progressive deterioration of the patient's functional andinterpersonal abilities in activities of daily living at home, school, or workdue to the pain.
• Patients with chronic primary pain (according to the typology defined by theInternational Classification of Diseases-11) and classified into one of the 4following categories:
• Chronic generalized pain
• Complex regional pain syndrome
• Chronic primary headache or orofacial pain
• Chronic primary musculoskeletal pain
• Pittsburgh Sleep Quality Index (PSQI) must be completed by the patient and the scoremust be available (for randomization purposes)
• Have access to an internet connection as a self-administered questionnaire is tocomplete online, and at least have access to the online platform for CBT treatment ifinsomnia is detected
• Affiliation to a French social security system
• Free informed consent

Exclusion Criteria:

• Patients undergoing cancer treatment or who have completed treatment within the last 2years
• Patient with a chronic inflammatory disease (e.g. rheumatoid arthritis, ankylosingspondylitis, chronic inflammatory bowel disease, Horton's disease, Wegener's disease,myositis, Still's disease, lupus erythematosus, etc.)
• Immunocompromised patient
• Patient with severe psychiatric pathology that does not allow study follow-up (at thediscretion of the investigator)
• Patient already treated for a sleep disorder by a sleep specialist (the onlyprescription of hypnotics is not considered as a criterion of non-inclusion)
• Patient follow-up difficult (for geographic motives or other reasons)
• Patient under judicial protection of incapable adults or guardianship
• Refusal to participate in the research